Antihypertensive Flashcards
What are Angiotensin converting enzyme (ACE) Inhibitors?
Medications that inhibit the ACE enzyme, lowering blood pressure
Name a common ACE Inhibitor.
Captopril
What is Enalapril?
An ACE Inhibitor used to treat high blood pressure
What is Enalaprilat?
The active form of Enalapril
What is Perindopril?
An ACE Inhibitor that helps manage hypertension
What are selective α1 adrenoreceptor antagonists?
Medications that block α1 adrenergic receptors, lowering blood pressure
Name a selective α1 adrenoreceptor antagonist.
Doxazosin
What are selective central α2 adrenoreceptor agonists?
Drugs that stimulate α2 adrenergic receptors in the central nervous system
Name a selective central α2 adrenoreceptor agonist.
Methyldopa
What are NO modulators?
Medications that increase nitric oxide levels, causing vasodilation
Name a NO modulator.
Sodium nitroprusside
What is Glyceril trinitrate?
A NO modulator used for angina and heart failure
What are Angiotensin II 1st type (AT1) receptor blockers (ARB)?
Medications that block the AT1 receptor to reduce blood pressure
Name an ARB.
Valsartan
What are calcium channel blockers (dihydropyridine)?
Medications that inhibit calcium influx in vascular smooth muscle
Name a dihydropyridine calcium channel blocker.
Nifedipine
What is Amlodipine?
A dihydropyridine calcium channel blocker for hypertension
What are selective α1, nonselective β adrenoreceptor antagonists?
Drugs that block both α1 and β adrenergic receptors
Name a selective α1, nonselective β adrenoreceptor antagonist.
Labetalol
What is Carvedilol?
A nonselective β blocker with α1 blocking activity
What are β adrenoreceptor antagonists?
Medications that block β adrenergic receptors, reducing heart rate
What are central α2 adrenoreceptor and imidazoline agonists?
Drugs that act on central nervous system receptors to lower blood pressure
Name a central α2 adrenoreceptor agonist.
Clonidine
What are diuretic agents?
Medications that promote diuresis to reduce blood volume
Name a loop diuretic.
Furosemide
What is Hydrochlorothiazide?
A thiazide diuretic used to treat hypertension
What is Indapamide?
A thiazide-like diuretic for managing high blood pressure
What is Spironolactone?
A potassium-sparing diuretic
What are 2nd generation β adrenoreceptor antagonists?
Medications that selectively block β1 receptors
Name a 2nd generation β adrenoreceptor antagonist.
Metoprolol
What is Bisoprolol?
A selective β1 adrenoreceptor antagonist
What is Nebivolol?
A 3rd generation β adrenoreceptor antagonist with vasodilatory effects
What are selective imidazoline receptor agonists (SIRA)?
Drugs that target imidazoline receptors to lower blood pressure
Name a selective imidazoline receptor agonist.
Moxonidine
ACE inhibitor
Captopril, enalapril,enalaprilat,perindopril
ARB
Valsartan
Calcium channel blockers (dihydropiridine)
Nifedipine and amlodipine
Selective alpha 1 adrenoreceptor antagonist
Doxazosin
Selective alpha 1 and non selective beta adrenoreceptor antagonist
Labetalol and carvedilol
Beta adrenoreceptor antagonist
2-metaprolol, bisoprolol,3-nebivolol
Selective central alpha 2 adrenoreceptor agonist
Methyldopa
Central alpha 2 and imidazolin I1 agonist
Clonidine
Selective imidazolin I1 receptor agonists
Moxonidine
NO modulators
Sodium nitroprusside and glyceril nitrate
Factors determining BP
CMV,TPR, volume of circulating blood
Major regulatory systems of BP
ANS and RAAS
Angiotensin 2 acts on aldosterone leads to na and water retention and increase venous return,this leads to
Increase cardiac output
Compensatory mechanism for reduced vascular tone is
Increased HR
Compensatory mechanism for reduced CMV is
Vasoconstriction
RAAS increase BP by
Vasoconstriction and increasing the circulatory blood volume
What leads to increased renin production
Increased sympathetic stimulation, decrease BP, decreased renal blood flow, decreased na in distal tubules
Angiotensin 2 in AT 1 receptor
Increase vasoconstriction,ROS, sympathetic NS activity,ADH secretion, ventricular hypertrophy
Angiotensin 2 in AT2recetopr
Increased NO,na excretion and decreased endothelial hypoxic injury,bp
Late compensatory response
Cardiovascular remodeling
Primary drug group of antihypertensive
ACE1,ARB,BAB, Diuretic, Calcium channel blockers
Secondary drug group of antihypertensive agents
Central -SIRA,alpha 2 adrenoreceptor agonist
Peripheral -alpha 1adrenoreceptor antagonists, Mineralocorticoid receptor antagonist
Hypotensive activity is done by
Decreased afterload through arterial dilation and decreased preload through venous dilation ((diastolic end vol) and decreased CMV through reduced chronotropy and inotropy
Activity of ACE inhibitors
Cardiovascular remodeling, hypotension through vasodilation in both arteries and veins, decrease aldosterone secretion
Uses of ACE inhibitors
Arterial hypertension,CHF,CHD, diabetic nephropathy (captopril)
Side effects of ACE inhibitors
Dry cough (due to increased bradykinin) and hyperkalemia (decreased aldosterone), teratogenic
ARB doesn’t affect
Bradykinin metabolism
ARBs are
Valsartan, candesartan and losartan
Clinical use of ARB
Arterial hypertension and CHF
Side effects of ARB
Hyperkalemia and teratogenic
ACE inhibitors and ARB are
Linked with RAAS activity
Calcium channel blockers are
Arterial vasodilators
Names of calcium channel blockers
Nifedipine, amlodipine,nicardipine
Amlodipine duration of action
24hr
Uses of calcium channel blockers
Arterial hypertension, prevention stable angina pectoris attack,CHD(vasospastic form)
Side effects of calcium channel blockers
Constipation and peripheral edema(ankles)
BAB action
Decrease CMV through decrease HR and contractions and decrease renin secretion,1;2gen cause reflex vasoconstriction,3rd generation cause peripheral arterial vasodilation
Doxazosin action reduce pre and afterload ,so hypotensive effect,used in
Arterial hypertension
Side effects of doxazosin
Reflector tachycardia and first dose orthostatic hypotension and syncope
Imidazolin I1 receptor are located in
RVLM of medulla oblongata
SIRA action
Decrease SNS activity
Use of SIRA
Arterial hypertension and metabolic syndrome (increase tissue insulin sensitivity)
Clonidine side effects
Bradycardia, sedation,dryness of mouth
Use of clonidine
Antihypertensive therapy in urgent situations
Methyldopa cross BBB and is used for
Gestational hypertension
Methyldopa acts on
Presynaptic alpha 2 autoreceptors
Sodium nitroprusside action
Vasodilators and decrease pre and afterload through increased cGMP
Sodium nitroprusside use
Hypertensive emergency
Labetalol
Combined alpha and beta adrenoreceptor blocker
Labetalol is used in
Urgent and emergency hypertension